In the January 25, 2005, issue of the Archives of Internal Medicine, researchers from the University of Chicago and Stanford University School of Medicine use data from the National Center for Health Statistics to show that most of the growth in COX-2 use between 1999 and 2002 occurred in patients at little risk for side effects from the drugs COX-2s were developed to replace.
"We found a rapid nationwide shift away from older, inexpensive drugs with better established safety and efficacy to newer, costly drugs with no real history," said study author G. Caleb Alexander, M.D., M.S., instructor of medicine and a member of the MacLean Center for Clinical Medical Ethics at the University of Chicago.
"We pursued our analysis because of concerns that this was an example of overuse of a newer, more expensive class of medications," said co-author Randall S. Stafford, M.D., Ph.D., associate professor and Director of the Program on Prevention Outcomes and Practice at Stanford University. "As with other examples in the treatment of high blood pressure, diabetes and some infections, there appears to be a tendency for new drugs to be used in a wider array of situations than supported by scientific studies."
The COX-2 inhibitors, introduced early in 1999, were widely promoted as "super aspirin." Ordinary aspirin blocks both COX-2, which triggers inflammation, as well as COX-1, which protects the stomach lining and helps to decrease the risk of GI bleeds and stomach ulcers. These newer and far more expensive drugs were designed to target only COX-2 and to be used to treat patients with chronic inflammatory disorders such as arthritis.